AB0762 Incidence Of Anterior Uveitis In Axial Spondyloarthritis During Secukinumab Treatment: TWO YEARS REAL LIFE EXPERIENCE FROM TURKBIO REGISTRY
Authors: C. Akleylek, S. Akar, H. Cinakli, R. Piskin Sagir, B. N. Coşkun, A. Karakas, H. Apaydin, R. C. Kardaş, O. Ozdemir Isik, S. Hakbilen, B. Okyar, O. Sosyal, S. S. Koca, Y. Pehlivan, E. Dalkiliç, G. Can, İ. Sari, M. Birlik, F. Onen, S. Erten, M. A. Ozturk, A. Yazici, A. Cefle, S. Yilmaz, G. Yildirim Cetin, N. Akkoc, N. Yilmaz
Journal: Annals of the Rheumatic Diseases (2022)

Background Secukinumab (SEC), a human anti-IL-17A monoclonal antibody, has similar treatment response rates to tumor necrosis factor (TNF) inhibitors in patients with axial spondyloarthritis (SpA). However, the efficacy of SEC on anterior uveitis (AU) is unclear. Objectives This study aimed to evaluate the risk of new-onset or relapsing AU in axial SpA patients treated with SEC. Methods In this prospective cohort study, 130 axial SpA patients receiving SEC at the TURKBIO registry between 2019 and 2021 were evaluated. Demographic and clinical characteristics and data about the presence of AU pre or post-treatment were collected. The univariate and multivariate logistic regression analyses were performed to evaluate the predictors of AU development. Results The mean age of the patients (F/M: 59/71) was 47.4±10.9 years. The median follow-up time was 540 days (IQR: 330-630). SEC was the first biological agent in 50 (38.4%) patients and 35 (26.9%) patients were using at least one concomitant conventional synthetic DMARD (Table 1). While continued SEC therapy was in 93 (71.5%) patients, treatment withdrawal was in 37 cases (in 26 due to ineffectiveness, two adverse events and nine other reasons). Overall, 15(11.5%) patients had a history of AU before the SEC. During follow-up, AU attacks were seen in the 6 cases (4 were new-onset and 2 were flare) and 5 of these patients have a history of inadequate response to TNF inhibitors. The frequency of AU was calculated as 3.42 per 100 patient-years during SEC treatment. The only significant predictor of AU development was the baseline high C-reactive protein (CRP) level on multivariate analysis (p=0.003, OR: 1.063 [95% CI 1.021-1.107]). Table 1. Demographics and clinical characteristics of the patients Total (n:191) Gender (F/M) 59/71 Age (years) (mean±SD) 47.4±10.9 Diagnosis; n (%) AS 125 (96.2) nr-axSpA 5 (3.8) BASDAI (mean±SD) 47.2±20.48 Missing n (%) 4 (3.07) ASDAS (mean±SD) 3.32±0.92 Missing n (%) 14 (10.7) C-reactive protein (mg/L) median (IQR) 12.6 (4.67-22.62) Sedimentation (mm/h) median (IQR) 22 (9-42) Concomitant csDMARDs n (%) 35 (26.9) Secukinumab dose n (%) 150 mg 120 (92.3) 300 mg 10 (7.7) TNFi-naive patients n (%) 50 (38.5) Number of previous bDMARDs n (%) 1 36 (27.7) 2 23 (17.7) ≥ 3 21 (16.1) History of previous TNFi n (%) Monoclonal TNFi 64 Etanercept 16 AS; Ankylosing spondylitis, nr-axSpA; Non radiographic axial spondyloarthritis, BASDAI; Bath Ankylosing Spondylitis Disease Activity Index, ASDAS; Ankylosing Spondylitis Disease Activity Score, csDMARD; conventional synthetic disease modifying anti-rheumatic drug, TNFi ; Tumor necrosis factor inhibitors, bDMARD ; biological DMARD. Datas were expressed as number (%), mean±SD or median (IQR). Conclusion In this real-life data from the TURKBIO registry, the incidence of AU in axial SpA patients treated with SEC was calculated as 3.42 per 100 patient-years. A high baseline CRP level was an independent factor for developing AU. Disclosure of Interests None declared